Out of 23 patients treated with Anastrozole and GH, excluded patients included 5 who were born with SGA/IUGR and 1 with Noonan syndrome. (c) Patients were excluded if short stature was due to nutritional, metabolic, or chromosomal abnormalities or due to being born small for gestational age/intrauterine growth retardation (SGA/IUGR). (b) ISS was defined as (i) short stature characterized by a height less than 2 standard deviations below the mean height for chronological age and sex without endocrine, metabolic, nutritional, or chromosomal abnormalities and (ii) peak GH responses to GH provocative test with two different pharmacological stimuli > 5.5 ng/mL measured by ICMA. The following inclusion criteria were applied to these patients: (a) GHD was defined as either (i) short stature characterized by a height less than 2 standard deviations below the mean height for chronological age and sex or (ii) poor growth (growth velocity ≤ 25 percentile) of corresponding chronological age or (iii) peak GH responses to GH provocative test with two different pharmacological stimuli ≤ 5.5 ng/mL measured by immunochemiluminometric assay (ICMA). We identified 23 patients with a diagnosis of short stature, GHD, or ISS and treatment with GH and Anastrozole. We reviewed the charts of these patients to identify those treated with Anastrozole in addition to GH therapy. We identified 419 patients with those diagnoses. We identified patients between 12 and 18 years who had International Classification of Disease Ninth (ICD-9) and Tenth (ICD-10) diagnosis codes for short stature (ICD-9 783.43 and ICD-10 R62.52), GHD (ICD-9 253.3 and ICD-10 E34.3), or ISS (ICD-9 783.43 and ICD-10 R62.52). This is a retrospective chart review of male patients between 12 and 18 years of age who were seen at the pediatric endocrinology clinic at Rhode Island Hospital from January 2008 to July 2015. In the current study, we reviewed growth and height outcomes for six male adolescents with GHD or ISS treated with GH therapy to determine whether Anastrozole improves the adult height above the pretreatment PAH. However, data regarding adult height outcomes are limited. Studies involving AI in male patients with constitutional delay of growth and puberty, ISS, and GHD suggest that AI can delay bone age acceleration and increase predicted adult height (PAH). The identification of one male with a point mutation in the estrogen receptor gene and another male with a point mutation in the aromatase enzyme gene confirmed that estrogen is the principal hormone causing epiphyseal closure. ĪI block the aromatase enzyme, which prevents conversion of testosterone to estrogen, delays closure of the epiphyses, and may prolong the time period for pubertal growth. Different modalities to increase the adult height in pubertal adolescents with GHD and ISS include high dose GH therapy, gonadotropin releasing hormone analogs, and more recently aromatase inhibitors (AI). Maximizing the pubertal growth spurt in children with growth hormone deficiency (GHD) or idiopathic short stature (ISS) is challenging due to limited time available for linear growth. BackgroundĪpproximately 17% of adult male height and 12% of adult female height result from the pubertal growth spurt. However, the long-term safety and efficacy of aromatase inhibitor use in pediatrics remain limited. Anastrozole and GH therapy can be effective in augmenting adult height without significant side effects. Net height gain was 7.3 cm compared to pretreatment PAH ( ) and overall the mean adult height remained 3.5 cm below MPTH. The mean height SDS improved to (range +0.08 to +1.92, ). At NAH, the mean chronological age was years (range 15.9–18.1 years) and height was cm (range 168.5–173.4 cm). Patients received Anastrozole for an average of 30.5 months (range 19–36 months). Prior to Anastrozole treatment, the mean chronological age was years (range 13.7–14.4), bone age was years (range 12.5–14), mean height SDS was (range −0.8 to −2.3), and mean PAH was cm (range 153.5–168.6). We identified 23 patients (5 SGA/IUGR, 1 Noonan syndrome, 6 GHD, and 11 ISS). The primary outcomes are NAH compared to mid-parental target height (MPTH) and predicted adult height (PAH). Retrospective review of 419 charts from 2008 to 2015. We examined the effect of Anastrozole and GH therapy on near adult height (NAH) with pubertal males with GHD or ISS. Data on adult height outcomes of the use of Anastrozole and Growth Hormone (GH) in pubertal males with Growth hormone deficiency (GHD) and Idiopathic short stature (ISS) are limited.
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